Provider Demographics
NPI:1689690877
Name:BETHESDA SURGICAL PC
Entity Type:Organization
Organization Name:BETHESDA SURGICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:828-285-0969
Mailing Address - Street 1:PO BOX 2896
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-2896
Mailing Address - Country:US
Mailing Address - Phone:828-285-0969
Mailing Address - Fax:828-285-9103
Practice Address - Street 1:111 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4409
Practice Address - Country:US
Practice Address - Phone:828-285-0969
Practice Address - Fax:828-285-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913458Medicaid
NC2022176Medicare PIN
F36502Medicare UPIN